The closure of walk in centres contributes to health inequalities

Guest blog by Cllr Sanchia Alasia, Labour Councillor for Barking and Dagenham

In my role as chair of the health scrutiny committee on Barking and Dagenham council, I have seen first-hand, how the new Clinical Commissioning Groups (CCG) set up by the government to replace Primary Care Trusts, are making decisions that are having negative impacts on my local community.

We currently have two walk in centres in the borough, one in barking and one in Dagenham.  The CCG recently announced that they were proposing to close the walk-in centre in Dagenham in March 2014, leaving only one walk-in centre in the borough.  My committee believe that the business case for this proposal is not sufficiently detailed, is unclear and has inaccuracies, with it primarily being a savings proposal of £530, 00 with no plans to re-invest this money back into patient care.

I believe that the measures proposed will reduce the range of choice and flexibility for local residents, coupled with the fact that we have noticeable health inequalities.   Patterns of employment in our borough show that our residents have higher levels of shift work and low paid employment, which in turn reduce peoples’ flexibility to take time off during working hours to visit their GP.  Availability of appointments are an issue, with a mystery shop showing that it was very difficult to get an appointment in the same week as phoning.  Walk in centres also provide provision for those who are not registered with a doctor and were set up to improve people’s access to primary care as well as respond to the busy lifestyles that many face.  With our walk-in centres being open to 10pm and on weekends, those that struggle to find GP appointments have access to primary care through the centre.  No proper analysis has been done by the CCG on patient flows through the walk in centre and the makeup of the local population surrounding it.

The walk-in centre is used by around 31,000 people every year and the closure of this walk-in centre is proposed without sufficient work on developments and advancements in primary care.  This means that it is likely that many of the residents who use the walk in centre currently will have to use local accident and emergency departments instead.

Monitor, the sector regulator for health services in England, has review the provision of walk-in centres.  More than 50 have closed with many more being reviewed.  The report outlines that some walk-in centre report high attendance in the evenings, weekends and bank holidays when GP’s are closed.  Surveys showed that people indicated that this was one of the main reasons for their attendance.  So the closure of the Dagenham walk-in centre will inevitably mean that more people will find it difficult to access primary care services, when demand for GP services is increasing.  The report also shows that walk-in centres were contracted to offer health promotion and disease prevention services for specific groups including the homeless, asylum seekers and those with drug use issues.  It could also result in higher attendances at our local accident and emergency department at Queens Hospital in Romford.  However, Queen’s hospital accident and emergency department, has had problems with getting to grips with demand, staffing issues and waiting times. It is consistently one of the worst performing hospitals for accident and emergency waits in England.  Queen’s like other hospitals has had trouble in attracting enough emergency department consultants, with locums often filling in.  Therefore the closure of the Dagenham walk-in centre risks increasing health inequalities if suitable alternatives are not put in place.

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